Provider Demographics
NPI:1588846703
Name:SUFFOLK CARDIOVASCULAR CONSULTANTS, PLLC
Entity Type:Organization
Organization Name:SUFFOLK CARDIOVASCULAR CONSULTANTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:LANDOLPHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-456-0044
Mailing Address - Street 1:1920 DEER PARK AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-3314
Mailing Address - Country:US
Mailing Address - Phone:631-392-1680
Mailing Address - Fax:631-392-1683
Practice Address - Street 1:1920 DEER PARK AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-3314
Practice Address - Country:US
Practice Address - Phone:631-392-1680
Practice Address - Fax:631-392-1683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186182207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty